When I was a kid I remember visual illusion pictures that gained popularity called autostereograms. In the picture, nothing was seen but two-dimensional colored dots that looked like a bad version of a Jackson Pollock painting. But staring at the picture in a special way produced a three-dimensional image that appeared before you. There was an episode of “Seinfeld” where Elaine tried to teach her boss, Mr. Pitt, how to see the image. In the tense interaction he pleads desperately, “Where is it!?” and she instructs, “Unfocus your eyes!” He cancels all of his meetings and spends the day staring at the picture, with increasing anxiety, trying to achieve the result. The act of trying to force the result is the exact thing that prevents him from seeing the image.
While attempting to assert control over Obsessive-Compulsive Disorder (OCD), many react with resistance to present experiences which achieves the exact opposite of the desired result. Mindfulness is a helpful component in the treatment of OCD. Mindfulness can be defined as the act of paying attention to the present moment with openness, curiosity and non-judgment. It involves acceptance of present observations and a willingness to experience them, even if they are unwanted OCD thoughts, feelings or bodily sensations.
In mindfulness and autostereograms, the experience of letting go of results needs to occur before there is ever hope of achieving results. There are no step by step instructions. It’s every man for himself and there is no guarantee of results. A person must step into the dark, not knowing if they are wasting their time, and not knowing what the outcome might be. And then all of a sudden, “What is happening? Is this what I think this is? Do I see something beginning to take shape? Yes, I do see something. Wow! It is a dinosaur with a backpack and running shoes on!” But the thing that is really amazing is that you become free. You now have the freedom to look around the entire picture without staring. This activity doesn’t cause the image to go away.
Everyone’s experience of mindfulness is different. It is something that you must read about, hear about, talk about, and practice to find your own way with it. There are so many facets to experience and a multitude of ways you can turn corners when finding new ways to exist in the moment. You will pick up information and file it away. A seed will be planted and it will bloom at some other time when you least expect it.
A good way to think about how to start the journey with mindfulness is to become a student. And I’m not talking about the type of student who is caught smoking in the bathroom. I’m talking about an assiduous student, a sponge, an eager beaver. We must take an open-minded, active role in learning that doesn’t stop once we acquired the information. It’s a practice for a lifetime. It’s a better way to live. Each of life’s experiences, internal and external, can be filtered through the screen of awareness, if we choose to allow it. The body of knowledge grows and one’s mindfulness practice strengthens. Every moment is a moment to practice. And OCD experiences are no exception.
OCD is a disorder comprised of intrusive, unwanted thoughts, feelings and bodily sensations. These internal experiences often feel unacceptable to the OCD sufferer. The general response humans have when something is uncomfortable is to avoid and attempt to change the uncomfortable experience. In OCD, these avoidance or neutralizing behaviors are called compulsions or rituals. Rituals can be observable behaviors or mental actions. In attempting to reduce uncomfortable thoughts or feelings by performing compulsions, OCD becomes reinforced. For example, if a person reduces their anxiety by washing their hands after touching a “contaminated” door knob, the relief sends a false message that the door knob was harmful. Mindfulness will assist a person in finding ways to make room for uncomfortable moments, which will ultimately weaken OCD because it helps to prevent rituals.
Suppose an OCD thought shows up that says, “Smother your baby with that pillow,” or feel free to insert any unwanted thought here. This thought creates a good deal of anxiety and uncertainty. The usual response of a client prior to treatment is to pay too much attention to the thought, assign meaning to the thought, and to try to control future occurrences of the thought. To the OCD sufferer, the mere presence of the thought suggests there may be some danger looming. The behavioral response is often resistance and panicked efforts to avoid having uncertainty about the feared outcome, in this case, harming your baby. This will probably include an analysis of the thought in attempt to unbury its meaning.
There is a choice about how to respond to a thought like this. The natural, knee-jerk reaction to something uncomfortable and uncertain is to resist having future occurrences of the thought to reduce doubt about your future actions. If you react in this way, you’ll find your OCD patting itself on the back. Mindfulness awards a person more freedom than a biological need to avoid pain. Just like the autostereogram, you are free. You are not bound by the idea that this thought can’t be or this feeling shouldn’t exist. The thought does exist…the feeling does exist. If you remember your mindfulness skills, all of a sudden there is a bigger space for the thought or feeling to reside.
What does it mean to make room for thoughts? To paint a picture, imagine you are locked in a small closet with your thoughts. There is barely any room to move and the thoughts are crowding you. Now imagine you step into a big gymnasium with those thoughts. You still occupy the same room as them, but they are much less intrusive. All thoughts are allowed to float around, unobstructed. They can enter and exit as they wish. The content of the thought doesn’t matter, even if it seems particularly deplorable or insulting to what you value. The response is the same. What is here, is here, and it is acceptable.
Having OCD requires experiencing many painful thoughts and emotions, particularly before it has been treated. There is a decision that one can make about how to respond to pain. If there are only two choices: 1.) Thinking about killing someone while begging, bargaining, kicking and screaming that this thought is unacceptable OR 2.) Thinking about killing someone and accepting the thought, most clients can tell me that number 2 is the better choice. The error that people make is the illusion of a 3rd choice. Many OCD clients have a fantasy about a 3rd choice where they eliminate the thought.
None of us can control every thought that enters our brain, it is simply the nature of how thoughts work. Believing or wishing that you can is an error that leads to a rejection of reality, an error that leads to additional suffering. This is why I believe it may be easier to accept an irreversible condition such as having your leg bitten off by a shark, because there is not the illusion of control present in OCD. This example is more absolute, so people become less caught up wishing for a different reality. If there were a choice, I would be behind my clients 100% in trying to battle their OCD thoughts. Since thoughts and feelings that arrive in the moment are outside of your control, the best response is acceptance. The Buddhist proverb, “Pain in inevitable, suffering is optional,” can be used as a reminder to observe and accept intrusive, internal experiences on the path to lower suffering.
Without present moment focus, individuals with OCD may become very distressed. Generally, if you ask an OCD sufferer how they are doing now, they admit they are handling the thought or emotion adequately despite discomfort. It is often the frustration of how long they have been experiencing the thought (past-oriented thinking) or the fear of how long they will have to experience the thought (future-oriented thinking) that causes much of the resistance. It is the waiting for the internal experience to end that is the problem.
I have experienced mindlessness and rejection of the current moment many times while taking yoga. This phenomenon occurs when I am in a difficult pose and I am present and mindful. Then the teacher says, “Three more breaths,” and I immediately reject the current moment and the struggle begins. Suffering increases. I am no longer present in the pose. I’m comparing this moment of discomfort to how it will feel when I have relief from the pose. Guess which one wins the comparison and ultimately my attention? If I become aware of this shift, I can re-enter the moment through acceptance. It is a pretty cool experience to play around with.
One of my clients shared a similar example when his sister was giving birth to her baby. Her doctor told her to experience her contraction as if she would be in it forever. Now that sounds a little nutty, right? How could that possibly help? Isn’t it your spouse’s job to watch the contraction monitor to tell you when your contraction is peaking, so you know it will be ending soon? As counter-intuitive as it may seem, arriving in the discomfort and perceiving it as forever will allow you to live with it differently. You will make room for the feeling, you have to.
In comparing current pain to a moment when you will have freedom from pain, the current moment will always lose, and internal resistance will increase. And when struggle increases so will suffering…and the cycle continues. With OCD spikes, live in the moment as if is it your new reality, as if you had chosen it. Let go of results. This is not to resign yourself to a lifetime of suffering, but to create a new relationship with anything scary or uncomfortable.
Imagine a person who wants to stop eating pizza to lose weight. When he stops eating pizza, there may be strong urges or desire to eat it again. Most likely, he wants the uncomfortable feelings of desire to go away and he wants thoughts about pizza to go away too. Because the thoughts and feelings are uncomfortable and don’t go away, he eats pizza again and they go away temporarily. When using a mindful approach, consider that it may be okay for desire and thoughts to be present. Maybe he can sit with the desire and make room for it. It can be liberating to have the freedom to choose, independent of thoughts and feelings. He may even purposely think about pizza so the desire rises. This way he can practice making room for desire. This type of exposure can help him strengthen his mindfulness skills and be empowered to deal with all his difficult emotions.
I have treated OCD clients with beliefs that certain feelings should be matched to certain types of moments. “I should feel sad at funerals and happy when I’m with my friends,” said a client expressing her emotional perfectionism. I remember getting a relaxation massage and thinking I wasn’t enjoying it enough. I thought, “Time is flying by, I must relax!” I held the false belief that if I asserted control over my thoughts and feelings, I could change the experience, but the exact opposite happened. This was lack of acceptance of the moment. Even though it wasn’t exactly what I would have liked it to be, it was the reality of the moment. It is okay that I had thoughts about the time. It is okay that I wasn’t perfectly relaxed. Facing reality will lower suffering, and mindfulness will open the door.
Meditation or yoga can create some powerful moments and magical feelings of oneness with being alive. But these feelings of great connectedness with the world and who you are will not occur every time. Going into the situation already trying to control it, “I would like to replicate that awesome meditation session I had last time,” is already attempting to control the process which is the opposite of living in the moment. These desires are normal and innate, however. So thoughts about what you want the moment to be will always arise. That is okay because it is part of the moment. So become the watcher of those thoughts too.
It is sometimes difficult for individuals with OCD, who experience discomfort with uncertainty and incompleteness, to learn a practice that does not have a step by step description or an emphasis on outcomes. You may wonder how you are going to put the information from this article into practice for your OCD. “Am I doing it right? What will I get out of this? Is it working?” Doesn’t this sound familiar to Mr. Pitt trying to figure out the autostereogram? Become the observer of those thoughts too. Noticing when you are attached to results is mindfulness. Try saying, “I just noticed a thought that I may not be able to do this.” Watching this thought is mindfulness. You’re doing it. Tell yourself, “Maybe I don’t have to change this moment….maybe it can be what it is.” There is no amount of thoughts and feelings that you cannot handle. Picture your internal experiences as if they are entering and exiting a waiting room you are sitting in…and just keep reading your magazine.